Communication & Medicine, Vol 8, No 2 (2011)

Non-verbal vocalizations, dementia and social interaction

Lars-Christer Hydén
Issued Date: 19 Jun 2012


In later stages of Alzheimer’s disease many people will engage in noise-making (screaming and other kinds of sounds), often experienced as interruptive by others. A problem with the noise-making is the difficulty in understanding the meaning of the noise. This study addresses two questions: to what extent is noise-making responsive to the ongoing interaction and is noise-making regarded as meaningless behavior by other participants? The analysis of selective examples shows that noises may be fitted into the conversational interaction to a certain degree and in some instances is also responsive to interaction. The co-participants tend to treat the noises as meaningful. A general conclusion is that if utterances and responses in interaction are treated as if they are meaningful, they will become meaningful in their consequences for all participants.

Download Media

PDF (Price: £17.50 )

DOI: 10.1558/cam.v8i2.135


Bourbonnais, A. and Ducharme, F. (2008). Screaming in elderly persons with dementia. A critical review of the literature. Dementia 7 (2): 205–225.
Byrne, K. and Orange, J. B. (2005). Communication enhancement for family caregivers of individuals with Alzheimer’s disease. In B. Davis (ed.) Alzheimer Talk, Text and Context. Enhancing Communication 169–189. New York: Palgrave Macmillan.
Chatterji, R. (2006). Normality and difference: Institutional classification and the constitution of subjectivity in a Dutch nursing home. In A. Leibing and L. Cohen (eds) Thinking about Dementia: Culture, Loss, and the Anthropology of Senility 218–239. New Brunswick: Rutgers University Press.
Clark, H. H. (1996). Using Language. New York: Cambridge University Press.
Cohen-Mansfield, J. and Werner, P. (1997). Typology of disruptive vocalizations in older persons suffering from dementia. International Journal of Geriatric Psychiatry 12 (11): 1079–1091.;2-P
Cohen-Mansfield, J., Werner, P. and Hammerschmidt, K. (2001). Acoustic properties of vocally disruptive behaviors in the nursing home. Gerontology 49 (3): 161–167.
Downs, M., Clare, L. and MacKenzie, J. (2006). Understandings of dementia: Exploratory models and their implications for the person with dementia and therapeutic effort. In J. C. Hughes, J. Louw and S. R. Sabat (eds) Dementia: Mind, Meaning and the Person 235–258. Oxford: Oxford University Press.
Goffman, E. (1967). Interaction Ritual. Essays on Face-to-Face Behavior. New York: Doubleday.
Goffman, E. (1981). Forms of Talk. Philadelphia: University of Pennsylvania Press.
Goodwin, C. (1981). Conversational Organization: Interaction between Speakers and Hearers. New York: Academic Press.
Goodwin, C., Goodwin, M. H. and Olsher, D. (2002). Producing sense with nonsense syllables: Turn and sequence in the conversations of a man with severe aphasia. In B. Fox, C. Ford and S. Thompson (eds) Language of Turn and Sequence 56–80. Oxford: Oxford University Press.
Hallberg, I. R. and Norberg, A. (1990). Staff’s interpretation of the experience behind vocally disruptive behavior in severely demented patients and their feelings about it. International Journal of Aging and Human Development 31 (4): 295–305.
Hamilton, H. E. (1994). Conversations with an Alzheimer's Patient. An Interactional Sociolinguistic Study. New York: Cambridge University Press.
Hamilton, H. E. (1995). Requests for clarification as evidence of pragmatic comprehension difficulty: The case of Alzheimer’s Disease. In R. L. Bloom, L. K. Obler, S. DeSanti and J. S. Ehrlich (eds) Discourse Analysis and Applications. Studies in Adult Clinical Populations 185–200. Hillsdale, NJ: Lawrence Erlbaum and Associates.
Hydén L. C. (2011). Narrative collaboration and scaffolding in dementia. Journal of Aging Studies 25: 339–347.
Hubbard, G., Cook, A., Tester, S. and Downs, M. (2002). Beyond words: Older people with dementia using and interpreting nonverbal behaviour. Journal of Aging Studies 16 (2): 155–167.
Hydén, L. C. (2008). Broken and vicarious voices in narratives. In L. C. Hydén and J. Brockmeier (eds) Health, Culture and Illness: Broken Narratives 36–53. New York: Routledge.
Hydén, L. C., and Örulv, L. (2009). Narrative and identity in Alzheimer's disease: A case study. Journal of Aging Studies 23 (4): 205–214.
Kitwood, T. (1997). Dementia Reconsidered: The Person Comes First. Philadelphia: Open University Press.
Kontos, P. C. (2005). Embodied selfhood in Alzheimer’s disease: Rethinking person-centred care. Dementia 4 (4): 553–570.
Lamar, M., Obler, L. K., Knoefel, J. E. and Albert, M. L. (1994). Communication patterns in end-stage Alzheimer’s disease: Pragmatic analyses. In R. L. Bloom, L. K. Obler, S. DeSanti and D. Ehrlich (eds) Discourse Analysis and Applications: Studies in Adult Clinical Populations 217–235. Hillsdale: Lawrence Erlbaum.
Lindholm, C. (2008). Laughter, communication problems, and dementia. Communication and Medicine 5 (1): 3–14.
Mishler, E. G. (1990). Validation in inquiry-guided research: The roles of exemplars in narrative studies. Harvard Educational Review 60 (4): 415–442.
Örulv, L., and Hydén, L. C. (2006). Confabulation: Sense-making, self-making and world-making in dementia. Discourse Studies 8 (5): 647–673.
Papousek, H., Jurgens, U. and Papousek, M. (eds) (1992). Nonverbal Vocal Communication. Comparative and Developmental Approaches. Cambridge: Cambridge University Press.
Prizant, B. M. and Wetherby, A. M. (1987). Communicative intent: A framework for understanding social-communicative behavior in autism. Journal of American Academy of Child and Adolescent Psychiatry 26 (4): 472–479.
Ramanathan, V. (1997). Alzheimer Discourse. Some Sociolinguistic Dimensions. Mahwah, N.J.: Lawrence Erlbaum Assoc.
Ryan, D. P., Tainish, S. M. M., Kolodny, V., Lendrum, B. L. and Fisher, R. H. (1988). Noise-making amongst the elderly in long-term care. Gerontologist 28 (3): 369–371.
Ryan, E. B., Byrne, K., Spykerman, H. and Orange, J. B. (2005). Evidencing Kitwood’s personhood strategies: Conversation as care in dementia. In B. Davis (ed.) Alzheimer Talk, Text and Context: Enhancing Communication 18–36. New York: Palgrave Macmillan.
Sabat, S. R. (2001). Experience of Alzheimer’s Disease. Life through a Tangled Veil. Oxford: Blackwell.
Sabat, S. R. and Harré, R. (1992). The construction and deconstruction of self in Alzheimer’s disease. Ageing and Society 12 (4): 443–461.
Sabat, S. R. and Harré, R. (1994). The Alzheimer’s disease sufferer as a semiotic subject. Philosophy, Psychology, Psychiatry 1 (3): 145–160.
Schegloff, E. A. (1992). Repair after next turn: The last structurally provided defense of intersubjectivity in conversation. American Journal of Sociology 97 (5): 1295–1345.
Small, J. A., Gutman, G. and Hillhouse, S. M. B. (2003). Effectiveness of communication strategies used by caregivers of persons with Alzheimer’s disease during activities of daily living. Journal of Speech, Language and Hearing Research 46 (2): 353–367.


  • There are currently no refbacks.

Equinox Publishing Ltd - 415 The Workstation 15 Paternoster Row, Sheffield, S1 2BX United Kingdom
Telephone: +44 (0)114 221-0285 - Email:

Privacy Policy